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AT THE END of the day who wouldn’t like to fuck like a porn star, fuck for two or three days?

Genuinely this is the most difficult substance I’ve ever worked with in over 20 years of addiction treatment. The dynamics of the drug, what it does to you, what it takes from you – depression, anxiety, isolation – can be crippling.

Sex and drugs often go hand in hand – they have done for decades.

In recent years, one drug in particular keeps popping up in discussions about sexual activity: G.

GHB (gamma hydroxybutyrate) or GBL (gamma butyrolactone), both often shortened to G or Gina, are drugs used socially and for the purposes of chemsex.

Chemsex is the use of drugs such as G, crystal methamphetamine, ketamine and mephedrone to enhance sexual activity. The practice is usually associated with men who have sex with men (MSM), often involves multiple people and can lead to sexual encounters that last for hours or days.

Slamsex is the term used when the above drugs are injected for a more intense high.

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Source: Shutterstock/VladOrlov

GHB is a synthetic drug used as an anaesthetic. It comes in a clear liquid or powder form and its potency varies. GBL is sold as a substitute for GHB. It’s found in cleaning solvents and converts to GHB when you swallow it.

“Sex and drugs have been synonymous for a very, very, very long time,” Adam Shanley, outreach worker with the Gay Men’s Health Service and coordinator with rapid HIV testing service KnowNow, said.

Many of the people who engage in chemsex do so simply for pleasure. Drugs such as G reduce inhibitions and can create a euphoric effect.

Others take part in chemsex for more complex reasons, Shanley said, such as intimacy issues; internalised homophobia; and religious or cultural shame associated with sex, and gay sex in particular.

Like many substances, some people use G socially and don’t become addicted. However, others find themselves becoming dependent on it.

Chemsex partners often meet via dating apps such as Tinder and Grindr. Dangers associated with the practice include overdosing and an increased risk of contracting an STI or HIV if protection is not used.

The practice is gaining traction in Ireland but is more common in the UK – where a number of men have died as a result of overdosing. London, for example, has developed a reputation as the “chemsex capital“.

David Stuart, manager of the chemsex support programmes at a sexual health centre in Soho said, of the 7,000 to 8,000 gay men who come through the clinic’s doors each month “3,000 are using chems and are coming here with the consequences of chemsex”.

Lining up G with tea

Shanley first became concerned about chemsex in Ireland about three years ago.

“There was a direct connection to a friend of mine. We were out one night and I was there the next morning when he was getting ready for work. He was making a cup of tea and dosing out his G for the day.

“I had heard about it happening elsewhere, in London for example. But I didn’t realise that it was so under the radar here that I didn’t even notice my friend was doing it.

“Then I started to hear about friends passing out at parties and about non-consensual sex at parties – both through my own circle of friends and work,” he told TheJournal.ie.

Overdoses and deaths

Shanley noted that G is “a really, really addictive drug”, adding: “It’s not just used for chemsex, it’s a club drug too.

“Some people might have started to use it for chemsex but their dependency grew and it started to become something that they needed to take more often just to stave off any sort of come down.

Before they knew it they were falling into a proper addiction. I know some people who were waking up in the middle of the night to take it.

Shanley said he’s aware of a number of people who have died as a result of overdosing on G.

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Source: Shutterstock/MR.WEERAWAT EAM-SA-ART

“It’s a very easy substance to overdose on. Unfortunately we know of a number of people over the last number of months and years who have died … Last year, three people that I know of died.”

Shanley said it’s difficult to quantify how many people have died as a result of this in Ireland because G usually only shows up in a person’s system for 12 hours and many toxicology tests don’t screen specifically for the drug.

“That skews the reality of problem,” he stated.

Shanley said some people overdose or become ill after taking G “due to naive drug use” or being unaware of the dangers of the drug.

The Gay Men’s Health Service and others are trying to make people aware that the potency of G can vary hugely, as can people’s reactions to the same amount.

“I might find 0.5ml euphoric, the same amount might be enough to send you into a coma,” Shanley said.

One in four men

A paper, compiled by Dublin-based researchers, published in the International Journal of Drug Policy last year assessed the prevalence of chemsex, associated behaviours and STIs among attendees at Ireland’s only MSM-specific sexual health clinic over a six-week period in 2016.

The response rate was 90% (510/568). One in four men (27%) reported engaging in chemsex within the previous 12 months, and half had taken two drugs during their last chemsex experience. One in five people (23%) reported that they or their partners had lost consciousness as a result of chemsex.

One in four men (25%) reported that chemsex was impacting negatively on their lives and almost one-third (31%) reported that they would like help or advice about chemsex.

Shanley said that, while the risks of chemsex must be highlighted, it’s important to note that, based on the snapshot provided in the survey, 75% of men who engage in chemsex said it didn’t impact negatively on their lives.

“At the end of the day who wouldn’t like to fuck like a porn star, fuck for two or three days? That is the effect that these drugs can have on someone.”

However, there is a darker side.

Genuinely, this is the most difficult substance I’ve ever worked with in over 20 years of addiction treatment. The dynamics of the drug, what it does to you, what it takes from you – depression, anxiety, isolation – can be crippling.

“If someone experiences loss, if someone has a medical diagnosis, loses a job etc – the effect of that on them … If there’s this tiny little bottle that you know will take away all the pain for two hours, you’ll continue to take that,” Ryall said.

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Source: Shutterstock/View Apart

He added that G is highly addictive and “can prey on very vulnerable people”.

Like heroin in Fatima Mansions in the 1980s, it can also destroy people.

Some people who use G at the weekend can have a terrible comedown on Monday morning, which leads to them starting to take the drug during the week.

“If you’re riddled with anxiety you might think, ‘One shot and I’ll be fine’, but then you need another one at 11am,” Ryall said.

He knows some people who “have to take G every 60-90 mins, 24-7″.

“That really does bring it home to you. You could be in a [counselling] session with people needing heroin – they would wait to take it afterwards.

“People needing G – they would start to shake, get convulsions, visually start to go. I’ll ask, ‘Can I get you a glass of water’ because they need another shot of G (then and there).”

Ryall has helped to secure a detox bed in Beaumont Hospital in Dublin for people who become addicted to G.

Numbing the pain

Ryall said G and meth have had a “far more detrimental effect” on the gay community in recent years than more ‘established’ drugs like cocaine and ecstasy.

Some club owners don’t want such drugs being taken on their premises so this “puts things underground”. Not everyone who uses G or meth engages in chemsex but an increasing number of people appear to be doing so.

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Source: Shutterstock/Rawpixel.com

Ryall said some people turn to drugs when they’re new to the gay clubbing scene – as a way to lose inhibitions and “heighten social ability”. Others use drugs to help numb the pain they’re feeling due to various personal issues.

“As soon as the (chemex) session starts off, the inhibition is gone, it’s all good again … When drugs become a problem, those issues can come to the fore,” he said.

Ryall said safety information about G and chemsex needs to be spread in pubs, clubs and colleges.

‘Going under’

Consent often comes up in discussions about chemsex. Ryall said there’s an issue with people “going under” or passing out post-G, adding:

“I don’t want to put across that this is about gay boys being promiscuous. A person who has become addicted to G may have a very poor sleeping pattern, they could be up for two or three days and want to sleep so they take a little more than usual, go under – certainly they are vulnerable.”

Ryall said a “large number” of people have engaged with him about chemsex – ranging in age from early 20s to early 50s. Some don’t necessarily want to stop using drugs there and then. They might be seeking advice or information, or come back further down the line if they think they have a problem and need support.

Others are not willing to stop using certain drugs altogether but may want to reduce their use.

“I engage with individuals where they are at and where they want to be at. You can’t impose what you want – just say, ‘Stop taking drugs.’”

Ryall said giving up certain drugs can be particularly difficult for some people as it could mean changing habits they’ve had for years, as well as relationships.

“If they are part of a scene and everyone around them is perhaps part of that scene, it’s very difficult to come out of it.”

Rising HIV rates

More than 200 people in Ireland were diagnosed with HIV in the first five months of this year. A total of 504 people were newly diagnosed with HIV in 2017, on a par with the 503 new HIV diagnoses in 2016.

Of the new diagnoses in 2016, just over half (51%) were among MSM. According to the Health Protection Surveillance Centre, this was the largest number of diagnoses ever reported in MSM, who remain the group most affected by HIV in this country. According to provisional figures, 235 MSM were diagnosed with HIV last year.

Shanley said the increase in the number of MSM being diagnosed with HIV in recent years is multifaceted but that chemsex may have played a role.

“One of the desired effects (of using drugs like G) is disinhibition during sex so safer sex practices are perhaps less of a priority.”

G cards

Shanley said stakeholders from various organisation such as the HSE, HIV Ireland, the Ana Liffey Drug Project and the Gay Men’s Health Service (GMHS) have come together to discuss chemsex and how to best support those who need help.

As part of his work with the GMHS, Shanley provides training for healthcare professionals and others who work in relevant areas on how to best support people seeking help or advice about chemsex.

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Source: Shutterstock/fongbeerredhot

“We need to make sure that staff are asking the right questions and providing a supportive environment when people present. They need to be clued in with the language that is used [about chemsex] and the supports that are needed and available.

“People need to feel they can open up and have that conversation.

At a very basic level, we need to get information to those who need it. If we improve that cultural competence in regard to chemsex culture in our support services, people are more likely to present and seek help.

Shanley said one or two people a week could contact him about chemsex – in person and online.

The GMHS has a profile on Grindr, for example, and some men feel more comfortable seeking information from an anonymous source.

“When they’re behind a keyboard people are more comfortable to talk,” Shanley said.

As well as always encouraging condom-use, the GMHS urges G-users to carry a ‘G card’ (available at various service providers and sexual health clinics), so first responders will know what they’ve taken if they do end up in hospital.

By carrying the card, medical professionals know how to best proceed and “that definitely helps”, Shanley said. He noted that people are often reluctant to carry such a card due to the potential stigma of saying they use drugs.

“People are much more likely to carry the card when they have experienced a negative outcome in the past, such as a stint in A & E. Then they’re a lot more likely to see its benefit or worth,” he added.

Another piece of advice given to people who use liquid G is to add a food colourant to the drug, making it easily distinguishable from water.

“One guy ended up in A and E because he overdosed after he picked up a glass which he thought was water and knocked it back, actually it was a large dose of G,” Shanley told us. He said the man in question ended up in a coma but luckily pulled through.

How chemsex-use in Ireland will develop is unclear, as is the long-term impact of G.

Ryall said: “I worry for sure about the long-term effect. It’s a very serious chemical you’re putting into your body.

“We’re in the first five to seven years [of this scene] in Ireland … That’ll be an interesting study to have in a few years’ time. The long-term damage, we don’t fully know.”

Want to talk about G or chemsex? Here are some of the support services available:

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